General and Minority Stress in an LGB Population in Flanders

Sexual orientation-based microaggressions and cannabis use outcomes among sexual minority individuals: The impact of negative affect and coping-motivated cannabis use

INTRODUCTION

Sexual minority individuals report significantly more cannabis use and problems than their heterosexual peers, possibly due to their frequent experiences with sexual orientation-based microaggressions. As a result, sexual minority individuals may turn to cannabis use to cope with the negative affect associated with these experiences. No known studies have tested this hypothesis; therefore, the current study tested if sexual orientation microaggressions are positively associated with negative affect (anxiety and depression), cannabis coping motives, and cannabis-related outcomes (frequency, problems); if coping motives are positively associated with cannabis-related outcomes; and if negative affect and cannabis use to cope with negative affect serially mediate the relation between sexual orientation microaggressions and cannabis-related outcomes.

METHODS

Sexual minority undergraduate students who reported cannabis use in the past three months (N = 328; 71.3 % cis-female) completed an online survey.

RESULTS

Microaggressions were significantly positively correlated with anxiety, depression, coping-motivated cannabis use, cannabis-related problems, non-sexual orientation-related stress, and overt sexual orientation-based discrimination. Additionally, after controlling for non-sexual orientation-related stress and overt sexual orientation-based discrimination, microaggressions were indirectly positively related to cannabis use frequency and problems via the sequential effects of negative affect and coping motives. This relation remained significant when examining negative affect specific to sexual orientation microaggressions and cannabis use to cope with this microaggressions-specific negative affect.

CONCLUSIONS

Results highlight the adverse impact of sexual orientation microaggressions in terms of negative affect and negative cannabis-related outcomes.

Minority Stress and Mental Health: A Review of the Literature

Lesbian, gay, bisexual, and transgender (LGBT) populations experience significant health disparities, theorized to result from LGBT specific minority stressors. The fully conceptualized Minority Stress Model was published more than 15 years ago. Minority stressors include external conditions and events, such as discrimination and victimization. Internal minority stressors include expectations of rejection and discrimination, concealment of minority identity, and internalizations of negative dominant cultural attitudes, beliefs, stereotypes, and values. Connection to sexual and gender minority communities is theorized to moderate the effects of minority stressors. In this integrative review, I examine two decades of research on minority stress. Based on this review, I highlight strengths and limitations of the model, and suggest next steps for moving minority stress research forward.

An assessment of the proportion of LGB+ persons in the Belgian population, their identification as sexual minority, mental health and experienced minority stress

BACKGROUND

Previous studies report vast mental health problems in sexual minority people. Representative national proportion estimates on self-identifying LGB+ persons are missing in Belgium. Lacking data collection regarding sexual orientation in either census or governmental survey data limits our understanding of the true population sizes of different sexual orientation groups and their respective health outcomes. This study assessed the proportion of LGB+ and heterosexual persons in Belgium, LGB+ persons' self-identification as sexual minority, mental health, and experienced minority stress.

METHOD

A representative sample of 4632 individuals drawn from the Belgian National Register completed measures of sexual orientation, subjective minority status, and its importance for their identity as well as a range of mental-health measures.

RESULTS

LGB+ participants made up 10.02% of the total sample and 52.59% of LGB+ participants self-identified as sexual minority. Most sexual minority participants considered sexual minority characteristics important for their identity. LGB+ persons reported significantly worse mental health than heterosexual persons. Sexual minority participants did not report high levels of minority stress, but those who considered minority characteristics key for their identity reported higher levels of minority stress. LGB+ participants who did not identify as minority reported fewer persons they trust.

CONCLUSIONS

The proportion of persons who identified as LGB+ was twice as large as the proportion of persons who identified as a minority based on their sexual orientation. LGB+ persons show poorer mental health compared to heterosexual persons. This difference was unrelated to minority stress, sociodemographic differences, minority identification, or the importance attached to minority characteristics.

Exploring Minority Stress and Resilience in a Polyamorous Sample

Polyamory is a type of consensual non-monogamy (CNM) in which participants engage in multiple simultaneous romantic and often sexual relationships with the knowledge and consent of all involved. CNM practitioners in general, and polyamorous people in specific, appear to be highly stigmatized due to their relational practices, and to experience acts of CNM-related discrimination, harassment, and violence. Conceptualizing this dynamic via minority stress theory predicts that this stigma and discrimination will lead to negative mental health effects for polyamorous individuals. However, recent research has begun to identify possible sources of resilience within polyamorous populations that may ameliorate these negative effects. This study investigated these hypotheses in a sample of 1176 polyamorous American adults utilizing structural equation modeling. Four constructs were assessed as potential resilience factors: mindfulness, cognitive flexibility, a positive CNM identity, and connection to a supportive CNM community. Results indicate that CNM-related minority stress was positively related to increased psychological distress, such as higher self-reported depression and anxiety symptoms. Mindfulness was found to have both direct and moderating effects on the relationship between minority stress and psychological distress, such that higher mindfulness attenuated the negative impact of minority stress. Cognitive flexibility also displayed direct and moderating effects, but in the opposite than predicted direction. Clinical and research implications of these findings are discussed, with an emphasis on expanding understanding of how anti-CNM stigma affects practitioners and improving clinical cultural competence with this unique and under-served population.

Gay-Specific and General Stressors Predict Gay Men's Psychological Functioning Over Time

Gay men experience various stressors, including gay-specific stressors such as discrimination and internalized homonegativity as well as general stressors such as occupational and financial strain. While a robust literature has examined how gay-specific stressors are associated with negative mental health outcomes among gay men, less attention has been paid to the association between general stress and gay men's psychological functioning or to how different types of stressors may interact to affect functioning. The current study sought to address this gap by examining the unique and combined associations between gay-specific external stress (discrimination), gay-specific internal stress (rejection sensitivity, internalized homonegativity, sexual identity concealment), and general stressors (e.g., academic difficulties) and negative affect and alcohol use over time. A total of 147 self-identified gay men living in the greater New York City area participated in a baseline assessment and a 7-week diary study. Univariate and multivariate results revealed that gay-specific external stress, gay-specific internal stress, and general stress were each positively and uniquely associated with higher mean levels of and greater fluctuations in negative affect over time, and general stress was positively associated with greater fluctuations in alcohol use over time. Multiplicative analyses indicated that individuals reporting high levels of stress in multiple domains experienced particularly high mean levels of negative affect. These findings highlight the unique contribution of general stress to gay men's functioning over time and underscore the importance of considering multiple forms of stress (i.e., gay-specific and general stress) and their interactions to better understand gay men's psychological functioning.

Concealing Concealment: The Mediating Role of Internalized Heterosexism in Psychological Distress Among Lesbian, Gay, and Bisexual Older Adults

Recent population-based studies indicate that sexual minorities aged 50 and older experience significantly higher rates of psychological distress than their heterosexual age-peers. The minority stress model has been useful in explaining disparately high rates of psychological distress among younger sexual minorities. The purpose of this study is to test a hypothesized structural relationship between two minority stressors--internalized heterosexism and concealment of sexual orientation--and consequent psychological distress among a sample of 2,349 lesbian, gay, and bisexual adults aged 50 to 95 years old. Structural equation modeling indicates that concealment has a nonsignificant direct effect on psychological distress but a significant indirect effect that is mediated through internalized heterosexism; the effect of concealment is itself concealed. This may explain divergent results regarding the role of concealment in psychological distress in other studies, and the implications will be discussed.

Social support and depressive symptoms among 'money' boys and general men who have sex with men in Shanghai, China

The primary objective was to examine prevalence and correlates of social support and depressive symptoms among male sex workers (known as 'money boys' (MBs)) and general men who have sex with men (MSM) in Shanghai. The Social Provision Scale (SPS), which consists of 24 items, scored out of 4 for social provision, was used to evaluate the functions of social relationships. The score for each item ranges from 1 to 4, with a higher score indicating more social provision. The overall mean SPS score was 68.1 (s.d.=6.53) for MBs and 69.3 (s.d.=6.99) for general MSM. Depression was measured with a 12-item version of the Center for Epidemiological Studies Depression Scale (CES-D), where a score of 9 has been recommended as the cutoff score to indicate possible depressive symptoms. The prevalence of depressive symptoms was 57.9%, with MBs having a higher level of depressive symptoms than general MSM (70.0% v. 46.1%) (odds ratio=1.86, 95% confidence interval=1.07-3.24). Social support was a protective factor for depressive symptoms (odds ratio=0.92, 95% confidence interval=0.89-0.96). MSM in China, particularly MBs, are vulnerable to low social support and high depressive symptoms, highlighting the need for tailored psychological programs targeting this population.

From coming out to visibility management--a new perspective on coping with minority stressors in LGB youth in Flanders

This article develops a model that describes relations among environmental characteristics, discrimination and visibility management, and the experience of minority stressors by lesbian, gay, and bisexual (LGB) youth. The article elaborates on how visibility management (i.e., regulating the exposure of one's sexual orientation) of LGB youth can function as a coping strategy and is, therefore, closely tied to the experience of minority stressors. Qualitative support is found for the theoretical model in conducting 24 in-depth interviews with LGB youth. The analysis also shows that LGB youth use specific mannerisms, gender-nonconformist behaviors, and other indirect cues to make themselves visible or invisible as LGBs.

Lesbian women coping with challenges of minority stress: A qualitative study

Aims: Even though homosexuality is apparently widely accepted, minority stress prevails. Successful coping may reduce the negative impact of minority stress on health. We wanted to explore lesbian women’s positive coping experiences related to sexual minority stress. Methods: A convenience sample of self-defined lesbian women living in Norway was recruited mainly via internet. Qualitative data about coping strategies were obtained as written answers to a web-based, open-ended questionnaire. Data were analysed with systematic text condensation supported by theories of stress and coping, and salutogenesis. Results: Openness about the lesbian orientation, and how disclosure was carried out, were means to counter anticipated prejudice. Maintaining dignity when prejudice appeared could be accomplished by actions to demand one’s rights or claim respect, or by unexpressed thoughts boosting self-respect when unable to talk back. Prejudice within family relations lead to compromises to enable contact, but never compromising self-respect. Underlying successful coping strategies we identified a personal conviction that being lesbian is respectable and worthy – lesbian confidence. Conclusions: Promoting lesbian confidence, a healthcare provider can contribute to psychological wellbeing and enhance health among lesbian women. Open lesbian women in the community, who are responded to in a positive or every-day-like manner, may nurture lesbian confidence and contribute to coping and health.

Stress-related growth, coming out, and internalized homonegativity in lesbian, gay, and bisexual youth. An examination of stress-related growth within the minority stress model

This study investigates how young lesbian, gay, and bisexual (LGB) individuals deal with coming out and how perceived personal growth may result from that experience. We considered stress-related growth as a mediator between coming-out experiences and internalized homonegativity (IH). Our sample was taken from an online survey and is comprised of 502 LGBs aged 14-30. The social environment's acceptance of an individual's sexual orientation and the individual's social identification influence stress-related growth. Several coming-out indicators influence internalized homonegativity and, although growth perception does not function as a mediator between coming out and internalized homonegativity, it has a direct effect on IH.